School of Population Health, University of Auckland, Auckland, New Zealand.
Victorian Pediatric Palliative Care Programme, Melbourne, Australia.
Bioethics. 2020 Sep;34(7):687-694. doi: 10.1111/bioe.12749. Epub 2020 Jun 19.
In 2017 and 2018, the English courts were asked to decide whether continued life-sustaining treatment was in the best interests of three infants: Charlie Gard, Alfie Evans and Isaiah Haastrup. Each infant had sustained catastrophic, irrecoverable brain damage. Dignity played an important role in the best interests assessments reached by the Family division of the High Court in each case. Multiple conceptions of dignity circulate, with potentially conflicting implications for infants such as Charlie, Alfie and Isaiah. The judgements do not explicate the conceptions of dignity upon which they rely. This article reconstructs the conceptions of dignity invoked in these judgements, finding that a broadly Kantian, agential conception dominates, under which human dignity requires the prospect of agency. This conception is situated within the broader body of thought on dignity, and the potentially adverse implications of applying the reconstructed conception in best interests assessments for infants with severely restricted consciousness are discussed.
2017 年和 2018 年，英国法院被要求就三名婴儿——查理·加德、阿尔菲·埃文斯和以赛亚·哈斯特鲁普——的持续生命维持治疗是否符合最佳利益做出裁决。这三个婴儿都遭受了灾难性的、无法恢复的脑损伤。尊严在高等法院家庭庭在每个案件中的最佳利益评估中发挥了重要作用。尊严有多种概念，对像查理、阿尔菲和以赛亚这样的婴儿可能有潜在冲突的影响。这些判决没有详细说明他们所依赖的尊严概念。本文重构了这些判决中援引的尊严概念，发现一个广泛的康德式的代理概念占主导地位，根据这一概念，人类尊严需要代理的前景。这一概念处于尊严的更广泛思想体系内，并讨论了在最佳利益评估中对意识严重受限的婴儿应用重构概念可能产生的不利影响。
